It’s common for one testicle to hang lower than the other. In fact, most men find that their right testicle usually hangs lower. Here’s an overview of why this occurs and when it may indicate an underlying condition.
Normal Anatomy
The testicles, also called the testes or gonads, are oval organs located in the scrotum. The scrotum is a pouch of skin that hangs below the penis and contains the testicles along with nerves and blood vessels.
The testicles are contained within a sac called the tunica vaginalis. This sac attaches the testicles to the scrotum and allows them to hang freely. The spermatic cord extends from the testicles up into the abdominal cavity. It contains blood vessels, nerves, and the vas deferens tubes that carry sperm.
Why One Testicle Hangs Lower
In most men, the right testicle hangs lower than the left. There are several theories as to why this occurs:
Temperature regulation
The scrotum hangs outside the body in order to keep the testicles slightly cooler than normal body temperature. This is important for healthy sperm production, which requires a temperature around 95°F.
When one testicle hangs lower, it can stay slightly cooler than the other. Having one higher and one lower testicle may help regulate temperature.
Dominant side
Similar to being left or right handed, most men have a dominant testicle side. The dominant side is often larger and hangs lower. The difference in size is usually subtle.
Extra “slack”
The spermatic cords are not exactly the same length on each side. If one cord has a bit more slack, that testicle may hang lower as a result.
Cremasteric muscle contractions
The cremaster muscles run along the spermatic cords. Contractions of these muscles pull the testicles closer to or further from the body to regulate temperature. The cremasteric reflex is stronger on the right side in most men, which could result in the right testicle hanging lower.
When to See a Doctor
In most cases, one testicle hanging lower than the other is completely normal and no cause for concern. However, see your doctor if you notice:
– Sudden swelling or pain in one testicle
– Changes in the size of one testicle
– A lump, bump, or swelling on a testicle
– Redness, oozing, or ulcer on the scrotum
These can indicate an infection, injury, or other condition like a varicocele (enlarged vein in the scrotum) that requires treatment. Seek medical care immediately if you experience severe, sudden testicle pain, which could be testicular torsion requiring emergency surgery.
Other Causes of Low-Hanging Testicles
While one lower testicle is normal, some medical conditions can cause both testicles to hang abnormally low in the scrotum. These include:
Infantile hydrocele
Fluid collects around a testicle, making the scrotum swell. This usually resolves on its own.
Inguinal hernia
Part of the intestine protrudes through a weak spot in the lower abdominal muscles, pushing down on the testicles and scrotum.
Varicocele
Enlarged veins in the scrotum cause swelling and downward pulling. This is a common cause of low-hanging testicles in adolescents.
Cremaster muscle injury
Damage to the cremaster muscles negatively affects the cremasteric reflex, allowing the testicles to hang too low.
Scrotal edema
Swelling of the scrotal tissues due to fluid buildup, infection, or trauma.
Testicular cancer
In rare cases, large testicular tumors can cause significant scrotal enlargement and low-hanging testicles.
If both testicles are hanging lower than normal, see a doctor to identify the underlying cause. Treatment depends on the specific condition.
Tips for Managing Low-Hanging Testicles
If your low-hanging testicles are simply due to anatomy and not a medical problem, here are some tips for managing discomfort:
– Wear properly fitted underwear to provide support. Boxers or briefs work well.
– Use a jockstrap for sports and other athletic activities.
– Treat swelling with cold packs and over-the-counter pain medication.
– Wear loose pants and avoid restrictive clothing.
– Gently pull on the scrotum several times per day to help stretch the cremaster muscles.
– Improve posture and do Kegel exercises to strengthen pelvic floor muscles.
See your doctor if you have persistent symptoms of heaviness, swelling, or pain in the scrotum. Underlying conditions often require treatment.
The Takeaway
It’s normal for one testicle to hang slightly lower than the other in most men. This asymmetry helps regulate temperature and happens due to anatomy. Sudden changes in testicle size or position could signal a problem. See a doctor for severe scrotal pain, swelling, lumps, or other changes. Manage discomfort from low hangers with supportive underwear and proper clothing. While annoying, mildly low-hanging testicles themselves are not dangerous in healthy males.
| Cause | Description | Treatment |
|---|---|---|
| Temperature regulation | One lower testicle stays cooler, enabling sperm production | None needed |
| Dominant side | One testicle is naturally larger and hangs lower | None needed |
| Extra cord slack | Varied spermatic cord length results in asymmetry | None needed |
| Cremasteric reflex | Right cremasteric muscle contractions pull testicle down | None needed |
| Infantile hydrocele | Fluid around testicle causes swelling | Usually resolves on its own |
| Inguinal hernia | Intestine protrudes through abdominal wall into scrotum | Surgical repair |
| Varicocele | Enlarged scrotal veins cause downward pulling | Surgery or embolization |
| Cremaster injury | Damage to cremaster muscles impairs reflex | Treatment depends on severity |
| Scrotal edema | Fluid buildup in scrotal tissues | Address underlying cause |
| Testicular cancer | Large tumor mass causes scrotal enlargement | Surgery, chemotherapy, radiation |
Frequently Asked Questions
Is it normal for one testicle to be higher than the other?
Yes, it is completely normal for one testicle, usually the right one, to hang lower than the other side. This minor asymmetry is present in most males.
What health conditions can cause low-hanging testicles?
Medical conditions that may cause low-hanging testicles include hydrocele, hernia, varicocele, cremasteric muscle injury, scrotal edema, and rarely, testicular cancer. Underlying conditions should be evaluated by a doctor.
When should I see my doctor about low-hanging testicles?
See your doctor if you have pain, swelling, lumps, or other changes in the testicles. Immediately seek care for sudden, severe testicular pain that may indicate torsion. Seek evaluation if both testicles are hanging very low or if the condition interferes with physical activity.
Are low-hanging testicles harmful?
Mildly low testicles due to normal asymmetry are not harmful. However, severely low-hanging testicles or scrotums can indicate an underlying condition that needs treatment, or can cause discomfort. Tightly pulling the scrotum can also damage muscles and tissues.
How are low-hanging testicles treated?
Treatment isn’t usually needed for normal low-hanging testicles. To manage discomfort, wear supportive underwear, use cold packs and OTC pain medication, perform cremaster stretches, and avoid restrictive clothing. Underlying conditions like hernias, varicoceles, or tumors require specific surgical and medical treatments.
Conclusion
It’s common and expected for one testicle to hang slightly lower than the other. Temperature regulation and anatomy account for this harmless asymmetry seen in most males. While not serious on its own, a change in testicle position or a very low-hanging scrotum can indicate an underlying medical condition needing evaluation. See your doctor for testicular swelling, pain, or lumps. Manage discomfort from normal low-hanging testicles with supportive underwear, proper hygiene, and over-the-counter pain medication. Contact a doctor if symptoms persist.
